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Long-term follow-up of diabetic macular edema treated with dexamethasone implant: a real-life study

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Abstract

Aims

To evaluate the efficacy and safety of intravitreal dexamethasone implant (DEX-implant) for diabetic macular edema (DME) in real-life practice with an extended follow-up for up to 5 year.

Methods

This multicentric retrospective study reviewed 227 eyes of 152 patients with DME treated by DEX-implant. Main outcome measures included changes in best corrected visual acuity (BCVA), central macular thickness (CMT), time to retreatment and incidence of adverse effects.

Results

The mean number of DEX-implant received by patients was 2.6 (± 2.2) with a mean (SD) follow-up of 20.1 (± 15.8) months, median [IQR] 15.8 [7.4–30.1]. The mean time of retreatment was 6.9 months. The mean maximal BCVA gain during follow-up was 12.3 (± 12.7) letters. A gain of ≥ 5, ≥ 10 and ≥ 15 letters from baseline BCVA was obtained for 71.8%, 48.9% and 34.8% of eyes, respectively. A total of 62.6% of eyes presented a significant anatomical response (decrease of CMT ≥ 20%), and DME was resolved (absence of cystoid macular spaces on OCT) in 37% of cases at the end of the follow-up. A transient increase in intraocular pressure ≥ 25 mmHg occurred in 14.1% of eyes, and cataract surgery was performed for 49.1% of the phakic eyes during the follow-up. Four eyes developed a proliferative diabetic retinopathy.

Conclusion

This large cohort study showed favorable long-term outcomes when using DEX-implant, which provides substantial long-term benefits in the treatment of DME in real life.

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All data and materials are available upon request.

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Author notes

  1. Thibaud Mathis and Théo Lereuil have contributed equally to this work.

Authors and Affiliations

  1. Service D’Ophtalmologie, Hôpital Universitaire de La Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, 103, Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France

    Thibaud Mathis, Théo Lereuil, Amro Abukashabah, Philippe Denis & Laurent Kodjikian

  2. Laboratoire UMR-CNRS 5510 Matéis, Université Lyon 1, Villeurbane, France

    Thibaud Mathis & Laurent Kodjikian

  3. EPIMOD, 75 route du Mas Vernon, Dompierre Sur Veyle, France

    Nicolas Voirin

  4. Alphavision Augenzentrum, Bremerhaven, Germany

    Aditya Sudhalkar & Alper Bilgic

  5. MS Sudhalkar Medical Research Foundation, Baroda, India

    Aditya Sudhalkar

  6. Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France

    Corinne Dot

  7. French Military Health Service Academy of Val-de-Grâce, Paris, France

    Corinne Dot

Authors
  1. Thibaud Mathis
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  8. Corinne Dot
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Corresponding author

Correspondence to Laurent Kodjikian.

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Conflicts of interest

Thibaud Mathis is consultant for Allergan, Bayer and Novartis Corinne Dot is consultant for Alcon, Allergan, Bayer and Novartis Philippe Denis is consultant for Alcon, Allergan, Istar, Novartis, Santen, Théa Laurent Kodjikian is consultant for Allergan, Alimera, Bayer, Horus, Novartis, Roche and Théa None of the remaining authors have any conflicting interests to disclose.

Ethical Standard

Research was conducted in accordance with the Declaration of Helsinki. An international review board approved the study (Ethics Committee of the French Society of Ophthalmology, IRB 00008855 Société Française d’Ophtalmologie IRB#1).

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Informed consent was obtained from all individual participants included in the study.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques

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Mathis, T., Lereuil, T., Abukashabah, A. et al. Long-term follow-up of diabetic macular edema treated with dexamethasone implant: a real-life study. Acta Diabetol 57, 1413–1421 (2020). https://doi.org/10.1007/s00592-020-01561-1

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